Saturday, 4 May 2013


When I was fresh new in the profession, I thought I would employ my go-getter, type A personality to get things going. To get things done. To prevent that mother from going home childless after nine heavy months. To save that leg from amputation. To stop cancer cells from growing. I pretty much believed, like many class 8 kids would after KCPE results, that I am the change I was looking for.

I do not know anymore.

In my first year, I was thrown into the deep end of things, without a floater and expected to be seen alive at the shore. In between my failed attempts to save lives and certify the ones I had lost, I was in utter confusion.

I could no longer tell whether the wetness down my face was sweat from my brow or tears of exasperation. I remember keenly my seniors warn me not to die with every dying patient, not to be too attached. That would affect my service-rendering. I was supposed to move on swiftly like batman from one death to another potential one. Struggling amidst limited or no resources to work. And work we did.

As an intern at the largest referral south of Kenya, I happened to rotate alone for 2 months in obstetrics and gynecology and surgery departments. It was my mandates to do all the night calls, find sleep at the25th hour of the day, and return early morning to memorize my patients’ menstrual cycles. Accurately. More like an illicit lover would need to do to prevent unwanted…well you know what. My routine life had changed without realizing it. In a quick spark, I had begun dying with every dying person, witnessing and officiating needless deaths. I would develop a deep sense of guilt.

The dewy mornings to work would more or less be like an eternal walk to a funeral. Funerals. Sending patients to buy essentials and hiding my guilt with a straight face. A face that masked the inner me, the deep personality that would ever so often, almost always be crying out for change. I would, and still do, work an an average of 10 straight hours. In risky ambiance. Expose my throat to that TB patient who had defaulted treatment and only God knows if he now has Multi drug resistant TB. Happy and eager to help him too nonetheless, after all I get paid for it; the government makes sure that I have a medical allowance of $7 in case it gets me as well. I would hug the infected air, I still do, knowing pretty well I would come back home and my loved ones would run to hug my dirty self. Isn’t that what they see the neighborhood do, why would I deny them this.

A patient would cough straight into my lungs as I struggle to fix the improvised chest tube, my motto; this man must live, the ink to certify a death is too expensive.

I would be left to explain to that woman with fibroids why she would have to do with blood on her bed sheets for a further month or two, the autoclave machine had broken down. To the child with cancer, I would pray and hope that the donors would show up again, like they did 3 months ago, if they didn’t I would sit and pray that the cancer cells would stand still like Joshua’s sun, invariably, this was a useless prayer. I often choked up tears, to maintain a strong face, as I saw them steadily walk towards death. I wondered whether they were scared to die. Were they like me?

Sometimes it got me too angry, and I would run to my room listen to gothic beats and promise myself never to go back to that place again. That place-the hospital. This would only last as long as the anger. Pent up emotions.

Some patients would shout, scream at me, I saw one slap a lady doctor colleague. They just cannot understand how you would stand and do nothing as they lose a loved one. Aren’t you a doctor? Isn’t your work to save lives? What they did not notice were the empty shelves. They also wouldn’t remember when I had to take antiretrovirals for an entire month that time I had an unimpressive contact with blood from a HIV patient. That I bore alone. Not even the people I live with knew why I would rush to the sink to vomit my intestines out  ever so often  thanks to the side effects the drugs had on me. My heroism had handed me a near death deal. Like a bolt.

Sometimes our health administrators would do their rounds, we all know who Dr.Kimani is. The man with his own ideas of how doctors’ lives should be. Some say he is a sadist. How else would you describe a man who made sure hell was always so near. Autocratic and clueless.

I became angry. Every time I would run around, get blood sample, rush up the the stairs that were built by the Chinese to the lab and back to get my seniors to teach me the art of this science, I would break down when all that was in vain. When my pen would be needed in the death certification book; this happens very many times. In just a year, I had witnessed a ‘genocide’ of sorts and  certified it. While the entire nation of Rwanda had to go through mass counseling for their genocide, I was left alone and in the dark. I had to deal with it myself and wake up the next day fit as a fiddle. I had to fit in society too.perfectly.

I was not particularly waiting or hoping to develop a thick skin. A kind of skin that makes me indifferent to deaths. I thank God I am not even close to that.

While this was happening, our country was up in political flames. When I tried to say I need someone who has gone through the experiences that I have to manage the system, I was quickly shut down. Remember how my female collegue was slapped, it felt like that. A million times. When our hopes were sky high with the new government, they cut down spending on health. That to me means, more hazardous working conditions. More empty shelves. More resignation letters from collegues who simply choose to save their own lives.

Today I was at work, even now if I am called I will be there in a split second. Tomorrow too. But I am not sure whether I will be of any help. It is not well with my soul. Maybe we need to go on strike again. It is said, that sometimes to move forward we have to take few steps back. But who will we do it for?  With Kenyans, at least the vocal ones, it is well with their souls.


With 34 billion shillings out of the expected total budget of 1.65 trillion Kenya Shillings, our government has yet again relegated your health and mine to a forgotten corner. The above figure translates to 2.01% of our total budget and about 2.8 % of the National GDP.

This represents budget ‘cutting’ of close to 60% from what was allocated last financial year. With the dwindling resources, come additional responsibilities for the Kenyan doctor, the promise of free maternal care in all government hospitals and free health care in all health centers and dispensaries. This free healthcare, for your kind information, would be approximated to cost about 20 billion shillings.

The amount allocated gives you just 850 shillings as the per capita allocation for health, meaning your government will only spend that much for your health, in all these programs that not only focus on treatment but prevention of maladies.

WHY is this? I know why. Simply because death and disease-disability are usually very much private affairs. You die alone, away from the glare of the public. Unlike roads which remain beautiful and soaring and therefore a very ‘real’ benchmark for seeking re-election.  To our leaders, it’s all about the next elections, I suspect.

I am still waiting, no abated breath though, for Kenyans to learn and act, probably react, like they did in social media a few days ago. As a doctor, I can only give the services I am facilitated to give. Demand for this right, it is your responsibility.

Friday, 3 May 2013

Study of a peculiar society, that loves pain- Kenya

"Oh ye foolish Galatians, who has bewitched you?" a voice cries from the desert. The annointed one remarked at the thought of the stupidity of his people.

Applies to all of us just right about now. The hue and cry about our politicians literary fists-on-the collars of the salaries team is a scene to adore. I mean it. We, the people so fondly in love with quick fixes and aversion of the truth. A people embalmed in the romance of collective amnesia which recurs every five years is a comedy of  sorts. Get a jar of popcorn and watch it replay in an exact same manner.

Here is the reality your eyes will see once you become honest with yourselves, foolish Galatians (oops..Kenyans)...

We get the leaders we deserve. Our leadership is a reflection of our society. The rot in our leadership is a direct mirror image of the rot in the most basic unit of society- the family.

How many of us are honest at our workplaces? How many make sure they work for the last coin paid even when nobody is watching? How many of you still yell at the top of your voices how you are underpaid yet you spend significant amount of time paid for, mostly by taxpayers for the civil servants, sipping lattes and catching up on bogus stories while serving the public an enhanced menu of impunity?

The difference between our leaders and us is that they are in the glee of the media. The reel always rolls at their actions.

Speaking of the same leaders, an alien in Kenya would be forgiven to think that our leaders are manufactured from some exclusive depot and fed on us without our say. False. We elect them. Given many choices, we make the wrong ones. Again and again.

Our leaders remain better than us. At their point of need, like salary increment, they speak in one voice. At our point of need,like  the elections, we disintegrate into un-useful tribal shadows.

We get the leaders we deserve. Change comes from us. From within us. The only thing that changes from top down is food as it evolves into you know what. Our change must be from bottom up. You know how.

As a society that always votes against its own interests every other 5 years, who would sympathize with us.